Provider Demographics
NPI:1730900093
Name:KATZ FABREGAS, ELISE (LCSW)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:KATZ FABREGAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:H
Other - Last Name:FABREGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:181 BRISTOL DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-3114
Mailing Address - Country:US
Mailing Address - Phone:516-850-0453
Mailing Address - Fax:
Practice Address - Street 1:848 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTH MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1210
Practice Address - Country:US
Practice Address - Phone:516-850-0453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0918521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical